A 66-year-old female patient was admitted to the Emergency Surgery Department of Shaanxi Provincial People’s Hospital in November 2019 due to sudden high fever accompanied by skin redness and pain in the whole abdomen and perineum. After systemic anti-infection and local drainage of perineum area, the patient was discharged with improved symptoms. However, the symptoms recurred 12 days later and the patient was admitted to emergency surgery again. After the treatment, the effect was poor, and the drainage volume was maintained at 100-150 ml/d. Multidisciplinary consultation was organized and after detailed medical history questioning by plastic surgeons, it was confirmed that the patient had received polyacrylamide gel (PAAG) injection for breast augmentation 30 years ago and was therefore transferred to plastic surgery for systematic treatment. According to the patient’s clinical manifestations, bilateral breast and abdominal wall imaging result and medical history, PAAG was diagnosed as chronic non-specific inflammation of the whole abdominal wall and perineum after breast augmentation. PAAG was removed by infra mammary fold incision, combined with liposuction tube vacuum suction and whole abdominal fascial space debridement and lavage drainage. Pathological examination of capsule tissue after the operation showed foreign body granulomatous inflammation, consistent with chronic non-specific inflammatory changes after PAAG injection. The patient recovered well after surgery and was discharged 7 days later. During the 6-year follow-up, the patient no longer experienced related symptoms and accepted the current breast shape. The patient is currently under continuous follow-up observation. The treatment process of this patient indicates that a detailed medical history, comprehensive physical examination, and clear diagnosis are key prerequisites for ensuring correct treatment. Ultrasound and MRI are important methods for assessing the residual and distribution of fillers. For injection augmentation surgeries, regular follow-ups after surgery are necessary.

Objective:To explore the correlation between weekend moderate-to-vigorous physical activity(MVPA), weekday sedentary behavior(SB)and the risk of frailty in the elderly population monitored by wearable devices, and to provide a scientific basis for lifestyle interventions for frailty in the elderly.Methods:This study was based on the data of the UK Biobank from 2013 to 2015.A cross-sectional study design was adopted, and 33, 212 elderly people aged 60 and above with complete physical activity monitoring data were selected.The Frailty Index(FI)constructed by the deficit accumulation method was used to assess the frailty status.The correlation between the combined effect of weekday SB and weekend MVPA and the frailty status was analyzed, and the differences between genders were explored.Results:There were significant differences in physical activity indicators among the elderly with different frailty statuses.As the degree of frailty increased, the MVPA-related indicators showed a downward trend, while the weekday SB time gradually increased.There were sex differences in physical activity patterns and frailties.Compared with women, men had longer SB time on weekdays, lower metabolic equivalent of weekly MVPA consumption, and higher MVPA time on weekends, but the frailties index of women was slightly higher than that of men.After adjusting for confounding factors, the frailty risks for men and women in the subgroup with the lowest weekday SB and the highest weekend MVPA duration decreased by 46.9% and 59.8%, respectively( P<0.001)when compared to the highest-risk group. Conclusions:Based on the monitoring data from wearable devices, elderly individuals who reduced their SB time during weekdays and increased their MVPA time on weekends were associated with a lower risk of frailty, especially among women; which providing a new perspective for lifestyle-based intervention strategies for frailty among the elderly.

A 66-year-old female patient was admitted to the Emergency Surgery Department of Shaanxi Provincial People’s Hospital in November 2019 due to sudden high fever accompanied by skin redness and pain in the whole abdomen and perineum. After systemic anti-infection and local drainage of perineum area, the patient was discharged with improved symptoms. However, the symptoms recurred 12 days later and the patient was admitted to emergency surgery again. After the treatment, the effect was poor, and the drainage volume was maintained at 100-150 ml/d. Multidisciplinary consultation was organized and after detailed medical history questioning by plastic surgeons, it was confirmed that the patient had received polyacrylamide gel (PAAG) injection for breast augmentation 30 years ago and was therefore transferred to plastic surgery for systematic treatment. According to the patient’s clinical manifestations, bilateral breast and abdominal wall imaging result and medical history, PAAG was diagnosed as chronic non-specific inflammation of the whole abdominal wall and perineum after breast augmentation. PAAG was removed by infra mammary fold incision, combined with liposuction tube vacuum suction and whole abdominal fascial space debridement and lavage drainage. Pathological examination of capsule tissue after the operation showed foreign body granulomatous inflammation, consistent with chronic non-specific inflammatory changes after PAAG injection. The patient recovered well after surgery and was discharged 7 days later. During the 6-year follow-up, the patient no longer experienced related symptoms and accepted the current breast shape. The patient is currently under continuous follow-up observation. The treatment process of this patient indicates that a detailed medical history, comprehensive physical examination, and clear diagnosis are key prerequisites for ensuring correct treatment. Ultrasound and MRI are important methods for assessing the residual and distribution of fillers. For injection augmentation surgeries, regular follow-ups after surgery are necessary.

Objective:To explore the correlation between weekend moderate-to-vigorous physical activity(MVPA), weekday sedentary behavior(SB)and the risk of frailty in the elderly population monitored by wearable devices, and to provide a scientific basis for lifestyle interventions for frailty in the elderly.Methods:This study was based on the data of the UK Biobank from 2013 to 2015.A cross-sectional study design was adopted, and 33, 212 elderly people aged 60 and above with complete physical activity monitoring data were selected.The Frailty Index(FI)constructed by the deficit accumulation method was used to assess the frailty status.The correlation between the combined effect of weekday SB and weekend MVPA and the frailty status was analyzed, and the differences between genders were explored.Results:There were significant differences in physical activity indicators among the elderly with different frailty statuses.As the degree of frailty increased, the MVPA-related indicators showed a downward trend, while the weekday SB time gradually increased.There were sex differences in physical activity patterns and frailties.Compared with women, men had longer SB time on weekdays, lower metabolic equivalent of weekly MVPA consumption, and higher MVPA time on weekends, but the frailties index of women was slightly higher than that of men.After adjusting for confounding factors, the frailty risks for men and women in the subgroup with the lowest weekday SB and the highest weekend MVPA duration decreased by 46.9% and 59.8%, respectively( P<0.001)when compared to the highest-risk group. Conclusions:Based on the monitoring data from wearable devices, elderly individuals who reduced their SB time during weekdays and increased their MVPA time on weekends were associated with a lower risk of frailty, especially among women; which providing a new perspective for lifestyle-based intervention strategies for frailty among the elderly.

Objective:To analyze the causes and clinical features of chronic suppurative lung disease(CSLD) in children.Methods:We retrospectivly analyzed the primary disease, imaging changes, electronic fiber bronchoscope changes, blood gas analysis, lung function, treatment outcome and other clinical data of CSLD in children hospitalized in our hospital from September 2018 to February 2020.Results:A total of 14 children with CSLD were collected, including six males and eight females, aged (5.9±2.7) years old.Among 14 cases of CSLD, six cases were diagnosed with upper airway cough syndrome, three cases with upper airway cough syndrome and bronchial asthma, two cases with cough variant asthma, and one case with combined immunodeficiency disease.There were different degrees of purulent inflammation under electronic fiber bronchoscopy, and three cases had airway inflammatory stenosis.The lavage fluid suggested neutrophil inflammation.Blood gas analysis was normal in ten cases and hypoxemia in four cases.In seven cases, pulmonary function examination was abnormal in six cases, and one case had emphysema on lung CT examination.After intravenous administration of antibiotics and sequential oral antibiotics, the symptoms of 14 children were relieved.Fourteen cases were followed up for 12 weeks.Among them, 12 cases had complete relief of clinical symptoms, one case had repeated cough with combined immunodeficiency disease, and one case was lost to follow-up.Conclusion:CSLD mostly has primary disease.Electronic fiber bronchoscopy is not only a necessary examination of CSLD, but also one of the important means for treatment.Purulent inflammation of the airways can lead to abnormal obstructive lung.Sufficient course of treatment and standardized use of antibiotics are the key to the treatment for CSLD.

Objective: To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion (I/R) injury in rats. Methods: Eighty clean-grade male Sprague-Dawley rats, aged 9-10 weeks, weighing 300-350 g, were divided into 4 groups (n=20 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R), dexmedetomidine group (group D), and dexmedetomidine plus ERK signaling pathway blocker PD98059 group (group P). Spinal cord ischemia was produced by cross-clamping of the abdominal aorta distal to the left renal artery for 25 min followed by reperfusion to establish the model of spinal cord I/R injury.Dexmedetomidine 1 μg/kg was intrathecally injected at 20 min before establishing the model in D and P groups, PD98059 2 mg/kg was given via the tail vein at the same time in group P, and the equal volume of normal saline was given instead in S and I/R groups.Five rats were selected at 6, 8, 10 and 12 h of reperfusion, and the modified Basso, Beattie, Bresnahan (BBB) scale was used to assess the hindlimb locomotor function.Five rats were sacrificed after assessing the locomotor function at 6 h of reperfusion, and the L_3-5 segments of the spinal cord were taken for determination of cell apoptosis (by TUNEL) and expression of phosphorylated ERK (p-ERK) (by Western blot). The apoptosis index was calculated. Results: Compared with group S, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in the other three groups (P<0.05). Compared with I/R group, the BBB scores were significantly increased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in group D, and no significant change was found in the apoptosis index or p-ERK expression in group P (P>0.05). Compared with group D, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was down-regulated in group P (P<0.05). Conclusion The mechanism by which intrathecal dexmedetomidine reduces spinal cord I/R injury is related to activating ERK signaling pathway in rats.

Objective To analyze the characteristics,risk and induced factors of intussusception in Peutz-Jeghers syndrome (PJS).Methods From March 2nd 2005 to May 25th 2013,a total of 130 patients with PJS were selected.The clinical data of patients were collected,which included gender,age,the diagnostic age of PJS,family history,the diagnostic age of intussusception,clinical features,location,treatment and the maximum diameter of polyps which caused intussusception.Kaplan-Meier was performed to analyze the cumulative risk of intussusception.Results Among 130 patients with PJS,90 cases had intussusception.The age when first time diagnosed was from four to 33,median age was 16.The cumulative risks of intussusception at 10,15,20,25 and 30 years were 12.308％ (16/130),31.538％(41/130),51.538％(67/130),64.615％(84/130) and 66.923％(87/130).There was no significant difference in the cumulative risk of intussusception between male and female; with family history and no family history (both P＞0.05).A total of 131 intussusception happened in 90 patients,of which diagnosed by surgery,imaging examination and history reviewer was 125,four and two times,respectively.The initial symptom of 111 times of intussusception was acute abdomen and 15 were abdominal pain and vomiting.The left five intussusception was found by regular:examination.One hundred and fifteen intussusception was in small intestine and 16 in colon.There was 127,three and one time treated with surgery,conservative treatment,endoscopic therapy (dual airbags intestinal endoscopic polypectomy),respectively.The maximum diameter of polyps which caused intussusception was from 15 to 70 mm,average 40 mm.Conclusions Intussusception of patients with PJS is at young age and with a high cumulative risk.Intussusception is generally caused by diameter over 15 mm polyps.

Objective To establish the quality standard of Catharsis Tea. Methods Rhei Radix et Rhizoma, Scutellariae Radix and Aurantii Fructus were identified by thin-layer chromatography (TLC). HPLC method was established for the determination of emodin and rhein, performed on SunFire C18 column (4.6 mm×250 mm, 5 μm), with methanol-0.1%H3PO4 (85∶15) as the mobile phase at the flow rate of 1.0 mL/min, column temperature at 30 ℃, and detection wavelength of 254 nm. Results The TLC was exclusive. Within the range of 0.448-1.344 μg, emodin presented a fine linear relationship, r =0.999 7. Within the range of 0.011-0.077 μg, rhein presented a fine linear relationship, r=0.999 8. The recovery of rhein and emodin was 98.52% and 97.53% with RSD of 1.02% and 1.15% (n=6) respectively.Conclusion The methods are reliable, accurate, reproducible, and can be used for the quality control of Catharsis Tea.

This study investigated the tight junction (TJ) protein expression of the intestinal mucosa in a rat tail-suspension model under simulated weightlessness. Twenty-four Wistar rats were randomly divided into three groups: CON group (n=8), control; SUS-14 d group (n=8), tail-suspension for 14 days; SUS-21 d group (n=8), tail-suspension for 21 days. Occludin and Zonula Occluden-1 (ZO-1) expression levels were determined by immunohistochemical analysis and mRNA fluorescent quantitative PCR. Plasma levels of diamine oxidase (DAO) and d-lactate were determined using enzymatic spectrophotometry. Immunohistochemical results for occludin and ZO-1 showed disruption of the TJs in the intestinal mucosa in SUS-14 d and SUS-21 d groups. The expression levels of occludin and ZO-1 in SUS-21 d group were lower than those in SUS-14 d group, and significantly lower than those in CON group (Occldin: 0.86±0.02 vs 1.01±0.03 vs 1.63±0.03 and ZO-1: 0.82±0.01 vs 1.00±0.02 vs 1.55±0.01, P<0.01). Moreover, the levels of plasma DAO and d-lactate in SUS-21 d group were higher than those in SUS-14 d group, and significantly higher than those in CON group (DAO: 27.58±0.49 vs 20.74±0.49 vs 12.94±0.21 and d-lactate: 37.86±0.74 vs 28.26±1.01 vs 17.76±0.91, P<0.01). There were significant negative correlations between occludin or ZO-1 expression levels and DAO (r (2)=0.9014, r (2)=0.9355, P<0.01) or d-lactate levels (r (2)=0.8989, r (2)=0.9331, P<0.01). Occludin and Zo-1 were reduced in intestinal mucosa both in mRNA and protein levels in the rat tail-suspension model. The significant negative correlations between expression levels of TJs and plasma levels of DAO or d-lactate support the hypothesis that intestinal permeability is increased due to a decrease in TJ protein expression during tail-suspension from 14 days to 21 days.

This study investigated the tight junction (TJ) protein expression of the intestinal mucosa in a rat tail-suspension model under simulated weightlessness.Twenty-four Wistar rats were randomly divided into three groups:CON group (n=8),control; SUS-14 d group (n=8),tail-suspension for 14 days;SUS-21 d group (n=8),tail-suspension for 21 days.Occludin and Zonula Occluden-1 (ZO-1) expression levels were determined by immunohistochemical analysis and mRNA fluorescent quantitative PCR.Plasma levels of diamine oxidase (DAO) and d-lactate were determined using enzymatic spectrophotometry.Immunohistochemical results for occludin and ZO-1 showed disruption of the TJs in the intestinal mucosa in SUS-14 d and SUS-21 d groups.The expression levels of occludin and ZO-1 in SUS-21 d group were lower than those in SUS-14 d group,and significantly lower than those in CON group (Occldin:0.86±0.02 vs 1.01±0.03 vs 1.63±0.03 and ZO-1:0.82±0.01 vs 1.00±0.02 vs 1.55±0.01,P＜0.01).Moreover,the levels of plasma DAO and d-lactate in SUS-21 d group were higher than those in SUS-14 d group,and significantly higher than those in CON group (DAO:27.58±0.49 vs 20.74±0.49 vs 12.94±0.21 and d-lactate:37.86±0.74 vs 28.26±1.01 vs 17.76±0.91,P＜0.01).There were significant negative co rrelations between occludin or ZO-1 expression levels and DAO (r2=0.9014,r2=0.9355,P＜0.01) or d-lactate levels (r2=0.8989,r2=0.9331,P＜0.01).Occludin and Zo-1 were reduced in intestinal mucosa both in mRNA and protein levels in the rat tail-suspension model.The significant negative correlations between expression levels of TJs and plasma levels of DAO or d-lactate support the hypothesis that intestinal permeability is increased due to a decrease in TJ protein expression during tail-suspension from 14 days to 21 days.